加味补肾活血汤外用辨证治疗肾虚血瘀型股骨粗隆间骨折的临床观察

Clinical Effect of Modified Bushen Huoxue Decoction for External Application in Treating Femoral Intertrochanteric Fracture

目的：研究加味补肾活血汤辨证治疗肾虚血瘀型股骨粗隆间骨折的临床疗效。方法：选取从2015年3月—2016年7月本院收治的肾虚血瘀型股骨粗隆间骨折患者40例作为研究对象,以随机数字表法均分为两组。两组均采取常规手术及PFNA内固定治疗方案。对照组经骨折处理后服用钙尔奇片和皮下注射鲑鱼降钙素;观察组在此基础上采用补肾活血汤湿敷治疗。观察两组患者治疗后的骨折愈合情况,比较两组患者治疗前后髋关节Harris评分及VAS评分,并检测两组患者相关骨代谢指标治疗前后水平变化。结果：观察组术后6周愈合率65.00%,术后3个月愈合率为90.00%;对照组则分别为35.00%和65.00%,观察组骨折愈合率明显大于对照组（P〈0.05）。两组治疗后组间比较,观察组术后2周骨碱性磷酸酶（BALP）、Ⅰ型胶原羧基端前肽（CICP）、Ⅰ型胶原羧基端交联肽（CTX-Ⅰ）水平明显低于对照组,而甲状旁腺激素（PTH）水平明显高于对照组（P〈0.05）。经治疗两组患者髋关节Harris评分显著升高,VAS评分显著下降;观察组治疗后VAS评分明显低于对照组,治疗后髋关节Harris评分明显高于对照组（P〈0.05）。结论：加味补肾活血汤湿敷辨证治疗肾虚血瘀型股骨粗隆间骨折能有效调节患者骨代谢,促进骨折的愈合并减缓患者疼痛。

Objective： To study the clinical effect of Modified Bushen Huoxue Decoction for external application in treating femoral intertrochanteric fracture. Methods： From March 2015 to July 2016,40 patients with femoral intertrochanteric fracture were treated as the research objects,and were randomly divided into two groups by random number table method. The two groups were treated with conventional surgery and PFNA internal fixation. The control group after treatment of fracture took Caltrate and subcutaneous injection of salmon calcitonin. The observation group on the basis used Bushen Huoxue Decoction for external application.The fracture healings of two groups were observed,and the hip joint Harris score and VAS score were compared between the two groups before and after treatment,and the changes of bone metabolism indexes were measured before and after treatment in the two groups. Results： The healing rate was 65% and the healing rate in 3 months was 90% in the observation group and the control group＇s was about 35% and 65%,respectively. The fracture healing rate of the observation group was significantly higher than that of the control group（P〈0. 05）. Between the two groups after treatment,the observation group＇ s bone alkaline phosphatase（BALP）,collagen type 1 carboxypropeptide（CICP）,type I collagen carboxy terminal telopeptide（CTX-1） 2 weeks after operation were significantly lower than those of the control group,and parathyroid hormone（PTH） levels were significantly higher than that of the control group（P〈0. 05）. After treatment,the Harris score of the two groups was significantly increased and VAS score was significantly decreased. The observation group＇ s VAS score after treatment was significantly lower than that of the control group. The posterior joint＇s Harris score was significantly higher than that of the control group（P〈0. 05）. Conclusion： Modified Bushen Huoxue Decoction in the treatment of kidney deficiency and blood stasis type of femoral intertrochanteric fracture can effectively regulate the bone metabolism of patients,promote the healing of the fracture and slow down the pain of the patients.